| NPI | 1033257712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA08517200) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DE C70003265) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2013-03-20 |