| NPI | 1215125851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 60807) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI MD11882) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD11882) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2020-12-09 |