| NPI | 1821226317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301104428) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301104428) |
| 208000000X Pediatrics (Licence: PA MT194439) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301104428) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2019-04-22 |