| NPI | 1699237289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0071504) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 323943) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 25669) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-11-07 |