| NPI | 1598845356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: NY 177371) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 177371) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: NY 177371) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-09 |