| NPI | 1316181308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 277746) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.098534) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD444594) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD040476) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0074078) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 53097) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 266226) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301101842) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101266160) | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2023-11-27 |