| NPI | 1326569625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 85956) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC LL40918) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: GA 85956) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-03-04 |