| NPI | 1639687031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A193217)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101273604)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-24069)  | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101273604)  | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-24069)  | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A193217)  | |
| Enumeration Date | 2018-01-19 | 
| Last Update Date | 2025-06-13 |