| NPI | 1053476028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.08383R) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 187044-1) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2015-04-24 |