| NPI | 1497224414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00597600) |
| Additional Taxonomies | 103T00000X Psychologist |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 35SI00597600) | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2019-04-17 |