| NPI | 1285745653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD037150L) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: PA MD-037150L) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-02-15 |