| NPI | 1053622969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD456323) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD456323) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA MD456323) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D76364) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2025-09-03 |