| NPI | 1669784674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC MD32636) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: SC MD32636) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2024-01-15 |