| NPI | 1922196278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ MA 27588) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD011266E) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |