| NPI | 1588835185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.203488) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: LA MD.203488) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 249091) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 236709) | |
| Enumeration Date | 2008-03-22 |
| Last Update Date | 2023-08-01 |