| NPI | 1912985565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA06259400) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD054329L) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 20064) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2012-10-25 |