| NPI | 1669556536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: CT 050976) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 050976) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2022-09-28 |