| NPI | 1851469787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD429633) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 133951-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA03493900) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2009-09-30 |