| NPI | 1245211432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 83989) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: VA 0101201144) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0102201144) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2022-08-31 |