| NPI | 1770673048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0073244) |
| Additional Taxonomies | 2084N0600X (Licence: DC MD33734) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D0073244) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2016-07-15 |