NPI | 1235493982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0081151) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101286033) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10393000) | |
Enumeration Date | 2012-06-27 |
Last Update Date | 2025-06-13 |