| NPI | 1578503025 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101272896)  | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 019938)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 019938)  | |
| Enumeration Date | 2006-06-06 | 
| Last Update Date | 2024-09-24 |