NPI | 1720282429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD444596) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101263878) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 270936) | |
Enumeration Date | 2007-06-14 |
Last Update Date | 2025-08-15 |