| NPI | 1649302100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: GA 85249) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME106827) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D65149) | |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2024-04-04 |