| NPI | 1891038824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 18165) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.139038) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0013127) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2020-09-09 |