NPI | 1295851285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 224849) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478103) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101277297) | |
Enumeration Date | 2007-03-21 |
Last Update Date | 2024-09-23 |