| NPI | 1467544361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA04217400) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-04-16 |