| NPI | 1700835386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 173950) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 173950) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 173950) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-17 |