| NPI | 1598923419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 271414) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 41667) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY P61398) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2016-02-16 |