NPI | 1053325639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA10442200) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: NJ 25MA10442200) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2023-12-12 |