| NPI | 1669447587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA068996) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 204385) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-02-24 |