| NPI | 1871960930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35135690) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD465345) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11740600) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE c7-0005849) | |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2024-04-12 |