| NPI | 1194907584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD443216) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A129117) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2024-08-21 |