| NPI | 1568525038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D00062661) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD036202) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101237993) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2024-06-27 |