| NPI | 1750589917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102-203679) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS015524) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0116019686) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-12-10 |