| NPI | 1477700185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V0916) |
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: PA os007280e) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS007280E) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2024-05-07 |