NPI | 1366486128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: PA MD073667L) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD073667L) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2017-01-30 |