| NPI | 1518488501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SD 18076) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NE 2668) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 2668) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD 18076) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-04-02 |