NPI | 1215922802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX L6960) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX L6960) |
Enumeration Date | 2005-09-20 |
Last Update Date | 2024-02-01 |