| NPI | 1942318050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX E5176) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX E5176) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX E5176) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2007-09-12 |