| NPI | 1629380043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NJ 25MA09387600) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MN 62370) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 62370) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2023-01-02 |