| NPI | 1922191725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD-6927) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-6927) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-09 |