NPI | 1013046341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA05127300) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 132910) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 18284) | |
Enumeration Date | 2007-03-04 |
Last Update Date | 2013-03-05 |