| NPI | 1265828446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO210542) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101023280) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101025230) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR DO210542) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-07-12 |