| NPI | 1629010665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0061839) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 150265) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236570) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2022-12-07 |