| NPI | 1609010156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M-11984) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M11984) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2019-05-21 |