| NPI | 1821259581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101245846) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0073124) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD038864) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-06-07 |