| NPI | 1467942797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 309799) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 29592) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 309799-01) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 65940) | |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2024-09-02 |