| NPI | 1891730842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD438359) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 18868) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101048597) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 223712) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 31332) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-09-27 |