| NPI | 1700866027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD059337L) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0041928) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD059337L) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2009-12-08 |