NPI | 1811318389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 153460) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 153460) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 153460) | |
Enumeration Date | 2013-12-30 |
Last Update Date | 2023-05-18 |