| NPI | 1851446843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CT 49285) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 253290) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-12-28 |