| NPI | 1992820898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY P41343) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 257195) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-09-08 |