| NPI | 1598798662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD035068) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236132) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-01-28 |