| NPI | 1376518977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD046183L) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 72629) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD046183L) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 72629) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2023-07-03 |