| NPI | 1134369531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 50553) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 265463) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CT 50553) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2015-08-03 |