| NPI | 1134874233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD R198195) |
| Additional Taxonomies | 2084P0805X (Licence: MD R198195) |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2022-02-16 |