| NPI | 1639291669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 14007) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: SC 14007) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2025-09-11 |