| NPI | 1871988584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A162067) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 304804) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 304804) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2024-04-23 |