| NPI | 1841554912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 027646) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2010-00858) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MD15849) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2018-08-17 |