| NPI | 1881804938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101246531) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60654147) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX S3691) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-06-10 |