| NPI | 1023256823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD067965L) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 033856) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD067965L) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 033856) | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |