NPI | 1801851027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX N2608) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ MA07931900) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101241594) | |
Enumeration Date | 2006-04-19 |
Last Update Date | 2021-04-26 |