| NPI | 1861836934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 276292) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2022-00376) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2025-02-28 |