| NPI | 1518152172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 61007) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AK 7312) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA A116329) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MD D0070374) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A116329) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 7312) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0070374) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2018-06-21 |