| NPI | 1043316094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101036149) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0050424) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC C89207565) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |