| NPI | 1992962708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CT 050899) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA 239256) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MA 239256) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-09-22 |