| NPI | 1407482508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A199034) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA12273700) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12273700) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A199034) | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2026-09-11 |