| NPI | 1952314320 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 20A5280)  | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 158730)  | 
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI DO00471)  | |
| Enumeration Date | 2006-08-15 | 
| Last Update Date | 2025-09-26 |