| NPI | 1093803702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 0000-27880) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 84795) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10767500) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 83654) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-03-10 |