| NPI | 1376858043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09648500) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 8373120) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 64697) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A150887) | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2024-12-17 |