NPI | 1184615536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MD D42459) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY 230033) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D42459) | |
Enumeration Date | 2005-11-03 |
Last Update Date | 2009-08-17 |