| NPI | 1497720312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 136250) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA058602) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 035477) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |