| NPI | 1760493787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB09146700) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NJ 25mb09146700) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 254561) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2025-08-19 |