| NPI | 1629276746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MB08671800) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: NJ 25MB08671800) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2024-03-19 |