| NPI | 1477596088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD033477L) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD033477L) |
| 2084P0805X (Licence: PA MD033477L) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-10-02 |