| NPI | 1396030631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10144800) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 18533) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 54157) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD462774) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 291999) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2018-08-05 |