| NPI | 1255619037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09699700) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011014863) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 279730) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2015-06-23 |