| NPI | 1093213217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA AP09799) |
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: LA AP09799) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA RN128743) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA AP09799) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: LA AP09799) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: LA AP09799) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2019-10-29 |