| NPI | 1588975312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q5097) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.121868) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.121868) | |
| Enumeration Date | 2010-06-26 |
| Last Update Date | 2015-07-16 |