| NPI | 1275530255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ND 13085) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 43591) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX g5516) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2019-03-21 |