NPI | 1790881944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA08104400) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ 25MA08104400) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2024-03-14 |