| NPI | 1801424478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME169894) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12071600) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 332359) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-04-21 |