NPI | 1750760948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TX R7181) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 309530) |
Enumeration Date | 2015-05-21 |
Last Update Date | 2018-12-13 |