| NPI | 1194248401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 308455) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11333100) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NJ 25MA11333100) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NY 308455) | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-10-27 |