| NPI | 1790045789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: RI 14305) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: RI LP02499) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MN 107756) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2014-08-06 |