| NPI | 1487729422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA TMD004826) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 66538) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101266757) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0101266757) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WI 66538) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: SD 5092) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-10-12 |