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 |