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 |