| NPI | 1326132093 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-17639) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301038650) |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: MI 4301038650) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-03-09 |