| NPI | 1912122060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD428426) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PA MD428426) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD428426) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD428426) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA MD428426) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-08-09 |