| NPI | 1932279718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD-037544-E) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0003974) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA MD-037544-E) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD037544E) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-04-19 |