| NPI | 1235292160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD037936) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 243295) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101245626) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD12515) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2017-10-09 |