| NPI | 1437150521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD4758) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0008584) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G14195) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |