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 |