| NPI | 1558384941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME71192) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 22678) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD058533L) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD 00047693) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-09-25 |