| NPI | 1194144311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 332872) |
| Additional Taxonomies | 2084B0002X Psychiatry & Neurology, Bariatric Medicine (Licence: NY 332872) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 332872) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2025-01-15 |