| NPI | 1881123347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 309506) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301112853) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A172541) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME154541) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T5478) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD480079) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2023-10-31 |