| NPI | 1841420726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CT 051681) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA AH 1918018-5244) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 291484) | |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2023-06-29 |