| NPI | 1093748626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 201037) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 201037-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2017029221) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-02-16 |