NPI | 1255081287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 74697) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 32583) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 74697) | |
Enumeration Date | 2022-03-24 |
Last Update Date | 2025-06-19 |