| NPI | 1205375722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 72594) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 313123) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 312123) | |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2024-09-13 |