| NPI | 1437167657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101043883) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0101043883) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: VA 0101043883) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-07-25 |