| NPI | 1538384003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: PA MD028700E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD028700E) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD028700E) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD028700E) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-07 |