| NPI | 1912079070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ MAO48915) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 140829) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 26121) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-10-01 |