| NPI | 1073824454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 286656) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS13068) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 286656) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS13068) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-09-26 |