| NPI | 1083942353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 021068) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 137209-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD4295) | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2009-11-25 |