| NPI | 1083766000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NJ 25MA05391500) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NY 142355-1) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |