NPI | 1023194289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G176220) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 25421) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 25421) | |
Enumeration Date | 2006-10-31 |
Last Update Date | 2022-04-21 |