| NPI | 1720274376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OK 4615) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4615) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2021-05-12 |