| NPI | 1336261098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10298500) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CT 042629) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 261183) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 042629) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-04-13 |