| NPI | 1871737759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD441815) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NJ 25MA09822900) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09822900) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2018-06-21 |