NPI | 1760878599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10496700) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 309405) |
Enumeration Date | 2015-04-08 |
Last Update Date | 2020-07-16 |