| NPI | 1013923812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A77157) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY 234917) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ MA80935) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A77157) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 234917) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-03-17 |