| NPI | 1063429629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: NJ MA057447) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ MA057447) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-02-13 |