| NPI | 1073669966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 141679) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 141679) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 141679) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NY 141679) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |