| NPI | 1487602330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101280875) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 103898-875) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 61313854) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID M9565) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA 61313854) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M9565) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478082) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-07-08 |