| NPI | 1760547970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM MD2016-0793) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX P0339) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NE 23762) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2021-07-27 |