| NPI | 1952806093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 66099) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-02861) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25IA12314000) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V0958) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME169478) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 101273) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI EMC0005540) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61591805) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 330789) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD485545) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35C.001588) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 29303) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101282811) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036169996) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A196183) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-02-03 |