| NPI | 1558749804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD483798) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A166303) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 285689) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2024-05-16 |