| NPI | 1023148772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SD 00016639) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: SD 00016639) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: SD 00016639) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-10-18 |