| NPI | 1508833351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AL DO308) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 1415) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2010-11-08 |