| NPI | 1457397903 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H5290) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036163207) | 
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101053849) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A55282) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IN 01059464A) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 052625) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX H5290) | |
| Enumeration Date | 2006-06-22 | 
| Last Update Date | 2025-03-12 |