NPI | 1043658305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A16243) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 55286) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-9789) | |
Enumeration Date | 2013-06-10 |
Last Update Date | 2024-01-26 |