| NPI | 1659420099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IA DO-05063) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MT 18550) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MT 18550) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-06-05 |