| NPI | 1639731177 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 84162-20) | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 65609) | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 8526) | |
| Enumeration Date | 2019-07-04 | 
| Last Update Date | 2024-12-10 |