| NPI | 1144513722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 9705666-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 9705666-1205) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2020-02-13 |