| NPI | 1023023116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0063323) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0010581) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2014-05-14 |