| NPI | 1982606018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 185314) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA07356300) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA 041970E) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2009-12-28 |