| NPI | 1568757599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS016987) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA OS016987) |
| 208000000X Pediatrics (Licence: PA OS016987) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2017-03-07 |