NPI | 1174889208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA12021900) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 278360) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12021900) | |
Enumeration Date | 2012-04-03 |
Last Update Date | 2024-03-15 |