| NPI | 1548316797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 076838) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 19123) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME63609) | |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2017-03-22 |