| NPI | 1295149797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036171344) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA OS022745) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 281371) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NY 281371) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OR 183329) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-09-11 |