| NPI | 1093925380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD152505) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD152505) |
| 207R00000X Internal Medicine (Licence: OR MD152505) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-09-06 |