| NPI | 1386838795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A121031) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD187583) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX p1330) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A121031) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2021-08-26 |