| NPI | 1164442273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A83546) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 211915) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.204402) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-03-29 |