| NPI | 1417985482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 59935-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 223339) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 45275) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 228521-1) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 16239) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 7390) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2013-02-18 |