| NPI | 1144372715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2014-01587) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 245491) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2014-01587) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 245491) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2014-09-08 |