| NPI | 1205023256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA11388700) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 266574) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2024-09-10 |