| NPI | 1053334417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 68484) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 22502) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 22502) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.22502) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.123406) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-41751) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101256396) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2014025047) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 15452) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2014-0705) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME-121239) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-04-06 |