| NPI | 1477636504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101031567) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 056282) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G140359) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-08-09 |