| NPI | 1497215693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD490578) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 316473) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12788200) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-07-31 |