| NPI | 1114188869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G71424) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 180840-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-19542-0) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 041726) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0023937) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME119950) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2024-12-24 |