| NPI | 1689888356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO BB4745785-2005018230) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 251879-1) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2010-09-03 |