| NPI | 1326067885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 229408) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101057427) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-09-06 |