| NPI | 1992239859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 325331-01) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME152592) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA md476440) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-10-29 |