| NPI | 1417920109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD036325) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101238534) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD431736) | |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2007-07-08 |