| NPI | 1982670279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD024464E) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: PA MD024464E) |
| 174400000X Specialist (Licence: PA MD024464E) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2012-10-10 |