| NPI | 1558477752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME88411) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 88411) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-02-10 |