NPI | 1760570915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: UT 370147-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 370147-1205) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 370147-1205) | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2021-12-16 |