| NPI | 1508945650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 124158) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 124158) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 124158) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-03-15 |