| NPI | 1649293515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-15284) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO R2C29) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 12229) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 22730) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D13793) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101022130) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 036762) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 36080) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-10-26 |