| NPI | 1083830871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD037775E) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH ID-47150) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA073170) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD037775E) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH ID-47150) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ MA073170) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2010-12-03 |