| NPI | 1316037682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 77404) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: DC MD32319) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IA 39184) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2022-03-17 |