| NPI | 1760461081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 101132) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD028065E) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD028065E) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2018-12-21 |