| NPI | 1497743918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 20A9536) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CO 38750) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM A-1243-03) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 38750) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A9536) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 38750) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NM A-1243-03) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA 20A9536) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NM A-1243-03) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-05-04 |