| NPI | 1295477743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 23655) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 113255) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 343562) | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2026-07-23 |