| NPI | 1548331226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KY 16835) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 16835) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-09-16 |