| NPI | 1760636864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D66971) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A119563) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD442724) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2013-12-11 |