| NPI | 1598736860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR0070310) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA OS015478) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-05-23 |