| NPI | 1689198350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0093357) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD210001976) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 305497) | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2024-02-06 |