| NPI | 1992090765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 33543) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL33543) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2023-01-20 |