| NPI | 1174576847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DC MD31936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD31936) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-03-08 |