| NPI | 1306825229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KS 05-27207) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2001009187) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO 2001009187) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 05-27207) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2026-07-28 |