NPI | 1255599965 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0013236) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 250166) |
Enumeration Date | 2008-05-29 |
Last Update Date | 2015-08-07 |