| NPI | 1043521412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 2578701) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 143410) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.125879) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME175683) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2025-09-08 |