| NPI | 1073600896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 234087) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NJ 25MA08023100) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25ma08023100) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-09-10 |