| NPI | 1710277256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: DC MD042556) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: DC MD042556) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD MD042556) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2015-06-30 |