NPI | 1316047889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA05202700) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 138490-1) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2023-04-27 |