NPI | 1497775753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NJ 25MA05484300) |
Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 153152) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2023-03-07 |