| NPI | 1881748275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA 478457) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 037088) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 215845) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-01-22 |