NPI | 1487695318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD070792L) |
Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: PA MD-070792-L) |
2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: PA MD-070792-L) | |
Enumeration Date | 2006-06-10 |
Last Update Date | 2017-07-07 |