| NPI | 1093344194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 330842) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A22974) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS024072) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-05-11 |