| NPI | 1518696756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0106557) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 113353) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 343289) | |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2026-07-20 |