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 |