| NPI | 1093934531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OK 26284) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 218356) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 218356) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2018-02-28 |