| NPI | 1164464392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D64309) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD036319) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101234986) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-09-03 |