| NPI | 1245674159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MT 116195) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 72466) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q9213) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036162523) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB11136400) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS19750) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 02007643A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2022019697) | |
| 2084P0805X (Licence: MI EMC0002521) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2025-04-10 |