| NPI | 1043715485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 309809) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25mb11122100) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 309089) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25mb11122100) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2023-10-04 |