| NPI | 1730115999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX J2274) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO 46633) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-08-19 |