NPI | 1093754210 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 194664-1) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 95214) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA06686400) | |
Enumeration Date | 2006-06-05 |
Last Update Date | 2007-07-08 |