| NPI | 1194985507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 252882) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09552700) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2024-11-08 |