| NPI | 1205046034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 106132) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 106H00000X Marriage & Family Therapist | |
| 208U00000X Clinical Pharmacology (Licence: NY 106132) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 106132) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-08-23 |