| NPI | 1033379805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 70788) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A124989) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX S5843) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2021-04-27 |