| NPI | 1932640125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1014207) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 310799) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 50211) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11095600) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2025-06-10 |