| NPI | 1346338613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 9900969) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 54844) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: GA 54844) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-08-01 |