| NPI | 1386225704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 336.132354) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 342559) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 76897) | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2026-08-03 |