NPI | 1295823656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA37642) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD037942L) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD037942L) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ MA37642) | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2019-08-05 |