| NPI | 1174941736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 281045) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC 203576) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD042276) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2015-09-01 |