| NPI | 1356634901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE c1-0011538) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD473795) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2025-04-16 |