NPI | 1457391310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09827200) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 043579) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 043579) | |
Enumeration Date | 2006-06-08 |
Last Update Date | 2021-08-05 |