| NPI | 1821070921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB12437800) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI DOS-819) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 328267) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME DO3965) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: HI DOS-819) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI DOS-819) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2025-05-08 |