| NPI | 1447518741 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09888000) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 17119) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0013163) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2020-12-15 |