| NPI | 1033596176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 74225) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036.154123) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 34.014710) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2020-11-10 |