| NPI | 1538736970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ P50KCZ) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12203100) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD491109) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2025-07-31 |