| NPI | 1528358652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09235300) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NJ 25MA09235300) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD442395) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-08-14 |