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 |