NPI | 1083900039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T8492) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 282697) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 282697) | |
Enumeration Date | 2011-06-28 |
Last Update Date | 2023-01-13 |