| NPI | 1306919444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000019917) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD040640L) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO R3M02) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2012-03-23 |