| NPI | 1285933994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD453850) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA10225200) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2018-01-16 |