| NPI | 1588974430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 21801) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD447238) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D79634) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2024-10-02 |