| NPI | 1548441348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD21667) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A52689) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL Me73907) | |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-20 |