| 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 |