| 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 |