| NPI | 1740225028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 204409) |
| Additional Taxonomies | 2084P0805X (Licence: NY 204409) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2023-07-03 |