| NPI | 1841750783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1016121) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 309996) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A184329) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-09-26 |