| NPI | 1700884889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD019569E) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA37294) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ MA37294) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2009-09-11 |