| NPI | 1770536070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI MD9267) |
| Additional Taxonomies | 174400000X Specialist (Licence: HI MD9267) |
| 208000000X Pediatrics (Licence: HI MD9267) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-12-20 |