| NPI | 1588947600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD469622) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 36019) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD469622) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AL 36019) | |
| Enumeration Date | 2011-09-25 |
| Last Update Date | 2023-03-08 |