| NPI | 1235142548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0059209) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 282149) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 49354) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 430149120) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MD20773) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2017-04-06 |