| NPI | 1942532957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR MD156250) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 234406) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD60452304) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI MD-12986) | |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2016-08-29 |