NPI | 1245506120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD462337) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A156154) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D0084491) | |
Enumeration Date | 2012-03-26 |
Last Update Date | 2023-02-09 |