| NPI | 1467949537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA AN1992975) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0027235) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD476357) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11361700) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 330500) | |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2024-08-06 |