| NPI | 1255314621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ME 018382) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D0065397) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 64322) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2019-10-03 |