| NPI | 1851592372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD 14022) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: HI MD 14022) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: HI MD 14022) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2007-07-08 |