| NPI | 1649231879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 49874) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CT 028531) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 49874) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 028531) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |