| NPI | 1205093242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 242658) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 46758) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA TD60632655) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2016-11-15 |