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 | 2024-11-19 |