| NPI | 1659598860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO 2023042846) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.088181) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-22092) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI MD17261) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-10-26 |