| NPI | 1699167767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NY 277865) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 277865) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |