| NPI | 1871683763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00038007) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00038007) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-07-24 |