| NPI | 1730254699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 79596) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G5522) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 1039873A) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |