| NPI | 1699729160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 222822) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC 7175) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M8536) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-08 |