| NPI | 1376789487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25M08878100) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA08878100) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2025-01-15 |