| NPI | 1750509329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 12823) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a103937) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 38196) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2009-10-19 |