| NPI | 1013204817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA MD.206561) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.206561) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2021-12-23 |