| NPI | 1881078780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 50418) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PR 29892-R) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-08-26 |