| NPI | 1245364975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 28547) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY 216378) |
| 2084P0805X (Licence: NY 216378) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 216378) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-11-11 |