NPI | 1962425702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY MD111744) |
Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY MD111744) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY MD111744) | |
Enumeration Date | 2006-07-25 |
Last Update Date | 2014-10-29 |