| NPI | 1508814047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 21365) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: SC 21365) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-10-09 |