| NPI | 1023074747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: DC MD5492) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MD D0014682) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-09-14 |