| NPI | 1992812762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301108828) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AK 6615) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: FL ME 86346) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-01-23 |