| NPI | 1669591012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 45393) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OK 38057) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX T2221) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AR E-5728) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MS 28707) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-09-05 |