| NPI | 1174608574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0014095) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD32059) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 20438) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-08 |