| NPI | 1841379534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT ct-033091) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT CT-033091) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 033091) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2014-06-06 |