| NPI | 1831331628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 313421) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 1.069722) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD476309) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A124342) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME136277) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2022-08-14 |