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 |