| NPI | 1184767717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 213449) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY 213449) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 051714) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-04-03 |