| NPI | 1508235359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL OS15103) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0102209406) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102209406) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MB12792300) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2025-09-12 |