| NPI | 1962448225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD010285E) |
| Additional Taxonomies | 2084P0805X (Licence: PA MD010285E) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-07-20 |