| NPI | 1376756148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD430840) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D0089800) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-09-05 |