| NPI | 1790197523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101280456) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD16296) |
| 208000000X Pediatrics (Licence: TN 58972) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 218784) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD16296) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI MD16296) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 73797) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 58972) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61400873) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301510614) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD214571) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 73797) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO Dr.0073997) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 58972) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2025-07-31 |