| NPI | 1336163526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WI 73781-21) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL 10600) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 48722) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CO 51125) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-08-28 |