| NPI | 1023230844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 2012-01291) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OT010508) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25mb08244700) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-03-24 |