NPI | 1306844691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 195151) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 195151) |
Enumeration Date | 2005-07-11 |
Last Update Date | 2023-07-05 |