| NPI | 1629128921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME 28395) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 28395) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2012-11-28 |