| NPI | 1124018056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 117284) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 61847) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G170998) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 74291-20) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 285944) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH EL10717) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 264936) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10930300) | |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2022-12-01 |