| NPI | 1164670717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA0899200) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 239118) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2022-09-30 |