| NPI | 1730642877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 306311) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 315245) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-02690) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 72245) | |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2024-10-31 |