| NPI | 1700223971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-43882) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-43882) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2018-06-24 |