| NPI | 1467569939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 13076) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00031805) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 48339) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-11-13 |