| NPI | 1619139441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q5092) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD435283) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q5092) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD435283) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-01-13 |