| NPI | 1235741596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA11888000) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 75500) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2023-11-09 |