| NPI | 1720289184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D66505) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0066505) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-09-16 |