| NPI | 1194992032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D76028) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 254909) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A122653) | |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2015-09-30 |