| NPI | 1396818753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MB05399000) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS-007105-E) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ MB05399000) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA OS-007105-E) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-10-10 |