NPI | 1336353051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA04185600) |
Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NJ 25MA04185600) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2021-06-22 |