| NPI | 1447480173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 20A12207) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N9827) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A12207) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX N9827) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2019-03-02 |