| NPI | 1992844294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD25132) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0002762) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101014651) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |