NPI | 1316190689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10397300) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 255496) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 220501) | |
Enumeration Date | 2008-10-30 |
Last Update Date | 2024-11-24 |