| NPI | 1073924312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q5091) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 11013667-1204) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO DR.0062014) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2024-05-08 |