| NPI | 1124473327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A151347) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A151347) |
| 174400000X Specialist (Licence: CA A151347) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2021-07-26 |