| NPI | 1053974071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA12442600) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 182572) | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12442600) | |
| Enumeration Date | 2019-04-16 | 
| Last Update Date | 2024-10-23 |