| NPI | 1982694683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0066406) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI 12873) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-02-08 |