| NPI | 1821387580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 281954) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 268564) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI 16019) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A143651) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-04-28 |