| NPI | 1043206998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-083573) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 221611) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 211611) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD477618) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2023-10-05 |