| NPI | 1336285261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 033886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 179918-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 179918) | |
| 207R00000X Internal Medicine (Licence: GA 033886) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2016-03-18 |