| NPI | 1093816159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 124779) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 124779) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 124779) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-10-20 |