| NPI | 1669402103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2005-0845) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO DR.0064112) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 210202) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 210202) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-10-17 |