| NPI | 1568691137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 47324) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX BP10043785) |
| Enumeration Date | 2009-07-04 |
| Last Update Date | 2014-06-09 |