| NPI | 1457317778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 21713) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 35602) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 35602) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 21713) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2014-10-15 |