| NPI | 1447757877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 306892) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 1.071764-DO) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS022143) | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-10-19 |