| NPI | 1013046341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA05127300) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 132910) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 18284) | |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2013-03-05 |