| NPI | 1598798662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD035068) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D0102092) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236132) | |
| 208000000X Pediatrics (Licence: MD D0102092) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2026-02-12 |