| NPI | 1780702522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: NY 142607) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 142607) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA03812600) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2013-04-08 |