| NPI | 1083688022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 53498) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD32786) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101047901) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-02-26 |