| NPI | 1932593852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD048185) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D009002) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD466276) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2020-10-22 |