| NPI | 1740487354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 29770) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL29770) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101250047) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-06-27 |