NPI | 1932417219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 263352) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 136547) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 263352) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 136547) | |
Enumeration Date | 2010-09-20 |
Last Update Date | 2023-03-07 |