NPI | 1366443434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0101029164) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 21761) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2024-05-05 |