| NPI | 1528017290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 50974-021) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 50974-021) | 
| Enumeration Date | 2006-05-09 | 
| Last Update Date | 2009-12-17 |