| NPI | 1366963381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AK 185478) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: PA OT017539) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 11709387-1204) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-08-23 |