| NPI | 1487818670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD041465) |
| Additional Taxonomies | 286500000X Military Hospital (Licence: CT 04923) |
| 282N00000X General Acute Care Hospital (Licence: CT 04923) | |
| 282N00000X General Acute Care Hospital (Licence: DC MD041465) | |
| 251S00000X (Licence: DC MD041465) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2014-10-27 |