| NPI | 1649324955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD032346-L) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD032346-L) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NJ 25MA05805100) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-02-18 |