| NPI | 1144584962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2020-04201) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101283242) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 331992) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2025-04-17 |