| NPI | 1689932816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD457460) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD457460) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 75883-20) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 75883-20) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-10-03 |