| NPI | 1508064114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N8634) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME157676) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 88221) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036161508) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35C.000015) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2023-01853) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-01-08 |