| NPI | 1760449342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AR E-3570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-3570) |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2018-03-17 |