| NPI | 1285694596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 13702) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 13702) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2010-07-19 |