| NPI | 1295864825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CT 26411) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 223252) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MO 2011001609) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: PA MD023115E) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2015-02-06 |