| NPI | 1265876833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A143230) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD047518) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101267136) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2023-12-29 |