| NPI | 1770744070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q0763) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD447097) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01071624A) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2014-10-11 |