| NPI | 1588892988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 261445) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 259400) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 133890) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2016-03-24 |