| NPI | 1346456654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD434927) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 268030) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA 4054121147) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA 4004111187) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA 4004111187) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-03-15 |