| NPI | 1841446580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: NY 202307) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 202307) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: NY 202307) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NY 202307) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2011-06-28 |