| NPI | 1992061436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX U9696) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD60739932) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD182379) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2026-04-20 |