| NPI | 1568673564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 127120) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 243446) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 222469) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 243446) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-12-30 |