| NPI | 1306307988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1025292) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 1025292) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 318940) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-11-10 |