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 |