| NPI | 1538103072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME95309) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A87202) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD026186) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 230543-1) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-113895) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-02-13 |