| NPI | 1336258029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0034787) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101041183) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD033022E) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 123251) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |