| NPI | 1639216575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 037165) |
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: GA 037165) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 037165) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2021-09-25 |