| NPI | 1811252646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NY 283475) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 283475) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 283475) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2019-04-16 |