| NPI | 1275953861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME169392) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CT 67223) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 82950) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2024-10-11 |