| NPI | 1659990216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11582400) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 325279) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME158008) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-05-23 |