| NPI | 1831222538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 230632-1) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 230632-1) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 5105014-1205) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 5105014-1205) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-09-09 |