| NPI | 1750579777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 1083623144) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME158053) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0068215) | |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2024-08-23 |