| NPI | 1295948792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0066026) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 239092) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME121102) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 112288) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-06-29 |