NPI | 1548274616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR0049854) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MO 2004015297) |
2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WA MD00043635) | |
Enumeration Date | 2006-07-27 |
Last Update Date | 2024-04-29 |