| NPI | 1447469416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 252014) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101016442) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-04-27 |