| NPI | 1922275189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2008007434) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR 157578) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2012-10-11 |