| NPI | 1871718130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 319233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 319233) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX K7031) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2023-07-22 |