| NPI | 1245203934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR0054599) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 79877) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 46885) | |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2016-05-04 |