| NPI | 1265747711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09274300) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01083911A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD16988) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 35572) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME144593) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2020010478) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD470370) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 263457) | |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2020-06-04 |