NPI | 1982996484 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME165024) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09383700) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 279903) | |
Enumeration Date | 2011-05-03 |
Last Update Date | 2024-01-12 |