| NPI | 1477538742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 47446) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD029815E) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101034605) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2019-05-02 |