| NPI | 1083820815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GU M001255) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GU M001255) |
| 2084P0805X (Licence: GU M001255) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-09-08 |