| NPI | 1841297009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ME MD13127) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G043952) |
| Enumeration Date | 2005-07-02 |
| Last Update Date | 2016-02-02 |