| NPI | 1972850170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX R1621) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R1621) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01082009A) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME171708) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2025-02-26 |