| NPI | 1295266161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-02042) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 319868) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102208075) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-12-01 |