| NPI | 1790765196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB05814700) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ 25MB05814700) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2024-03-15 |