| NPI | 1932207123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 23119) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: GA 23119) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: GA 023119) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AL 8447) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 8447) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: AL 8447) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-09-19 |