| NPI | 1841358223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 2616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 2616) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AZ 2616) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-03-17 |