| NPI | 1396324372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.154308) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD600004586) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 338718) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-12-08 |