| NPI | 1336155522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 42981) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D46807) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-5528) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-05-02 |