| NPI | 1851778344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0087003) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S3340) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD468491) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2020-10-30 |