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 |