| NPI | 1831172261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NJ 25MA06859700) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA MD421947) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2010-12-15 |