| NPI | 1548898232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 79235) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 327755-01) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-10-16 |