| NPI | 1609119353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 290023) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 193103) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 0361390776) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2024-09-20 |