| NPI | 1386106367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX V2241) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO DR0075537) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 20A24281) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-07-23 |