| NPI | 1326364233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 76647) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 0200) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 76647) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 0200) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2025-01-20 |