| NPI | 1497826051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0049894) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 7485) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME 018110) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2023-12-17 |