| NPI | 1184187742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301508548) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.46585) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 319937-01) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-03-15 |