| NPI | 1295851285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 224849) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478103) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101277297) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11499500) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2025-02-19 |