| NPI | 1962763227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities (Licence: IN 01043276A) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: IN 01043276A) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IN 01043276A) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |