| NPI | 1922426469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 260264) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 292330) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 292330) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2020-03-28 |