| NPI | 1669578688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D73337) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 245678-1) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 245678-1) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2015-10-14 |