| NPI | 1316918170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 200301488) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 122952) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200301488) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A66706) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AK 122952) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A66706) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2018-06-16 |