| NPI | 1457528218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DC MD039845) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA 133241) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX N6254) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2018-11-26 |