| NPI | 1780180299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 316258) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11651100) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101278101) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-09-12 |