| NPI | 1669683959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.121628) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME175934) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301097915) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 60595) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IN 01095870A) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2026-08-03 |