| NPI | 1841412053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 201000812) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2010015539) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 0434077) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-11-13 |