| NPI | 1952729543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C191957) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12003900) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.47611) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME128210) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01097812A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U6103) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD482689) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.15468) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2023-03069) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 320560) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2026-06-24 |