| NPI | 1982811998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD422906) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA08169700) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2024-01-02 |