| NPI | 1750649992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10066700) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 60 273414) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-11-05 |