| NPI | 1710417464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NJ 25MA12118400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA12118400) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP04079) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-07-31 |