| NPI | 1669587127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301086595) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000042585) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN MD0000042585) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-07-16 |