| NPI | 1598144800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 142879) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA PGY.202963) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2019-07-30 |