| NPI | 1225081946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MDAL31638) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD424693) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-11-16 |