| NPI | 1629179411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA07374100) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 25MA07374100) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2013-12-18 |