NPI | 1255758116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10198500) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 291645) |
Enumeration Date | 2014-03-27 |
Last Update Date | 2020-05-01 |