| NPI | 1801137377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: KS 04-21932) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MO R5P78) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |