| NPI | 1235718511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A24182) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 336099) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV DO3899) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-09-27 |