| NPI | 1831310853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA md054344l) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA M.D054344L) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA md054344l) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2009-04-23 |