| NPI | 1033679287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA MD-49503) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME154761) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2023-09-13 |