| NPI | 1073909479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 63246) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 278346) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 63246) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2022-03-25 |