| NPI | 1275871485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA MD-42473) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: IA MD-42473) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 272034) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IA MD-42473) | |
| 208M00000X Hospitalist (Licence: IA MD-42473) | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2021-09-16 |