| NPI | 1437102811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 38193) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD444647) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0058020) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-06-30 |