| NPI | 1306869961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 222997) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA MD430685) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PA MD430685) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD430685) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME94175) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-02-06 |