| NPI | 1295050193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 115794) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD445614) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 282165) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2025-05-07 |