| NPI | 1700101219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MP 0718) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA10105900) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NJ 25MA10105900) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MP 0718) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10105900) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MP 0718) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2020-03-06 |