| NPI | 1063096360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 87391-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125077591) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301517357) | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2026-07-01 |