| NPI | 1487756433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD028412E) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225XM0800X Occupational Therapist, Mental Health | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-09-10 |