| NPI | 1417044983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 173858) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 173858) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 173858) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 173858) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-08 |