NPI | 1609238815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD472717) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 293276) |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD472717) | |
Enumeration Date | 2016-03-26 |
Last Update Date | 2021-09-22 |