| NPI | 1356471999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 056532) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MD12132) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME58087) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-01-16 |