| NPI | 1205890282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 158850) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 158850) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NJ MA059107) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA059107) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-01-05 |