| NPI | 1376501908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236548) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD420459) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2022-08-09 |