| NPI | 1942640388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: MS 24662) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 24662) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2019-12-02 |