| NPI | 1922393909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 344692) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 60878239) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036133986) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A153719) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-17986) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 94058) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2021-02416) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2026-06-17 |