| NPI | 1457733719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA 19576) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL OS14427) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 5101024209) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-01-04 |