| NPI | 1407293897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 289277) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ R74039) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2018-03-17 |