| NPI | 1407975584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX l0600) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L0600) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TX l0600) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2026-03-06 |