| NPI | 1841371234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 49769020) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 49769020) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2009-11-03 |