| NPI | 1508922493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MAO8830100) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-06-06 |