| NPI | 1316328842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0061806) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 295184) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2019-09-18 |