| NPI | 1790172385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: AL MD.35580) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2023-06-08 |