| NPI | 1457365249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD429406) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0064790) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 243159) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-04-02 |