| NPI | 1417118977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101279246) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 12183) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME109521) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2024-03-05 |