| NPI | 1295795193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: PA MD030216 E) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NY 169683 -1) |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: CT 018986) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 018986) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2014-03-20 |