| NPI | 1598871097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD014403E) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA MD014403E) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD014403E) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2012-10-08 |