| NPI | 1063619773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 29996) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC ll29996) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 57376) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-01-10 |