| NPI | 1003890666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 39438) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA C177109) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C177109) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IN 01061506A) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2022-08-01 |