| NPI | 1447355417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101268579) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DC MD035014) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-05-08 |