| NPI | 1528697828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 329792) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12950000) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NJ 25MA12950000) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NY 329792) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2026-06-19 |