| NPI | 1972824340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MD D80340) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 29205) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD456179) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 281998) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D80340) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A166326) | |
| Enumeration Date | 2010-06-19 |
| Last Update Date | 2022-12-01 |