| NPI | 1447212998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 178633) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 178633) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 178633) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2008-04-14 |