| NPI | 1245255504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CO DR.0067952) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: KY 31734) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-01-31 |