| NPI | 1013038785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 169860-1) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 169860-1) |
| 2084P0805X (Licence: NY 169860-1) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-03-06 |