| NPI | 1013539147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NJ 25MA12022100) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 328168) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-07-21 |