| NPI | 1316046816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME105344) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 75023) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 339552) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-10-15 |