NPI | 1255690293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IA 40237) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IA 40237) |
Enumeration Date | 2012-05-11 |
Last Update Date | 2014-05-05 |