| NPI | 1386739209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042.0012539) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 054055) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 054055) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-05-13 |