| NPI | 1639144165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD-042761-L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD042761L) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD-042761-L) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2019-11-08 |