| NPI | 1275993628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS020449) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 18276) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 314153) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB10945500) | |
| Enumeration Date | 2016-02-28 |
| Last Update Date | 2022-07-21 |