| NPI | 1225268790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A140352) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 269127) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD14323) | |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2021-11-22 |