| NPI | 1629044078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MD D26533) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D26533) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D26533) | |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2018-03-17 |