| NPI | 1770756223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301508764) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 17089) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301508764) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI 17089) | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2023-05-04 |