| NPI | 1528324811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-46697) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 54419) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 26105) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301116693) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-01-06 |