| 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 |