| NPI | 1285374512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 343016) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 84576) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME171239) | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2026-07-06 |