| NPI | 1427554179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD61403873) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 65854) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 29151) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61403873) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-03-07 |