| NPI | 1184860603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A35265) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NV 10923) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI 9477) | |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2009-01-05 |