| NPI | 1154418457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD195476) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 219434) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 45810) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 33024) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G153499) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-09-21 |