| NPI | 1265886337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD472305) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME138045) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 340979) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2026-02-09 |