| NPI | 1841518008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101273667) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA09448100) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2022-03-25 |