| NPI | 1336204502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101036793) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D45744) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD21389) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2011-11-14 |