| NPI | 1467665703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 242280-1) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NM A-1551-10) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2024-05-24 |