| NPI | 1164650321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101265999) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101265999) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101265999) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2023-06-22 |