| NPI | 1720249923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB09269700) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS015306) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OT012570) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-07-22 |