| NPI | 1194749341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: AZ 18801) |
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities (Licence: AZ 18801) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 18801) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-07 |