| NPI | 1184276818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX 47613) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX 46728) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 33433) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2022-05-10 |