| NPI | 1073171047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301509548) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4351044534) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4351044534) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2024-08-01 |