| NPI | 1528109758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101246930) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0068401) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 48144) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-02-23 |