| NPI | 1740334267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 003515) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A87591) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD444265) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2019-03-28 |