| NPI | 1174582563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 2008-00531) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD425694) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D00075007) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2014-04-23 |