| NPI | 1306985114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G159543) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ MA064876) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-05-28 |