| NPI | 1538323951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0012861) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478569) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0027234) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11456900) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2025-02-19 |