NPI | 1639293103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA06552100) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ 25MA06552100) |
Enumeration Date | 2007-03-19 |
Last Update Date | 2010-09-24 |