| NPI | 1275654154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 209066) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101274737) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI EMC0002024) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11522700) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME153012) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD20000103) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0080358) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2023-06-23 |