| NPI | 1093746836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A119201) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA09342600) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-08-24 |