| NPI | 1952631715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA08915700) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NJ 25MA08915700) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD441647) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101259948) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA08915700) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101259948) | |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2025-02-04 |