| NPI | 1083679062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 200301378) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ND 5512) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 28290) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2012-09-26 |