| NPI | 1881798437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD0696731L) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WV 21534) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 21534) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 0064866) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 0064866) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 48310) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 83164) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2023-03-03 |