| NPI | 1922419811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-50417) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 76553) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 341465) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2026-05-06 |