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 |