| NPI | 1720491640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 36956) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 36956) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL36956) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-05-10 |