| NPI | 1245897180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD481354) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210011718) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 321990) | |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2024-04-17 |