| NPI | 1225110075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0027903) |
| Additional Taxonomies | 2084D0003X (Licence: MD D0027903) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2009-02-24 |