| NPI | 1356597975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD039274) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD MD0074005) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101246423) | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2016-01-28 |