| NPI | 1821096538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 42866) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD-018439E) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0007537) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-11-26 |