NPI | 1124033808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 176250) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: NY 176250) |
Enumeration Date | 2006-07-30 |
Last Update Date | 2024-06-18 |