| NPI | 1598798662 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD035068) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0102092) | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236132) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D0102092) | |
| Enumeration Date | 2006-07-09 | 
| Last Update Date | 2025-07-01 |