| NPI | 1225007271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 2375861) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0092757) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11148000) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NJ 25MA11148000) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 237586) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MD D0092757) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-09-25 |