| NPI | 1982839346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 274056) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 156931) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 274056) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 156931) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2017-12-20 |