| NPI | 1750492609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 17534) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 010292) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-01-04 |