| NPI | 1477723914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 203173) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 21477) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA lagetp) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA LA203173) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA 203173) | |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2019-03-15 |