| NPI | 1689829459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD038743) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C170980) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0090624) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101269625) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2025-12-09 |