| NPI | 1134230485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A65076) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 15385) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD16414) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A65076) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NV 15385) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-05-23 |