| NPI | 1356584213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 8919706-1205) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 8919706-1205) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2013-00030) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2013-00030) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2021-11-11 |