| 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 | 2023-11-06 |