| NPI | 1760177299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 14130772-1205) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 14130772-1205) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 14130772-1205) | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-09-17 |