| NPI | 1558379958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0019998) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0019998) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-12-19 |