NPI | 1982690525 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NJ 25MA09416600) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35048297) |
2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35048297) | |
Enumeration Date | 2005-09-20 |
Last Update Date | 2021-07-23 |