| NPI | 1205193711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD462437) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D85779) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD462437) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2025-07-28 |