| NPI | 1275564197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036098596) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME126265) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01075164A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 32549) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-00156) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 35837) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35C.001445) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0016976) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U4394) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-05-01 |