| NPI | 1902190457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0076515) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD039913) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101249904) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD444863) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2021-09-17 |