| NPI | 1588662720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 13618) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: AL 14706) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: GA 34053) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MS 13618) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2014-01-30 |