NPI | 1588894778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA 175781) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301094705) |
Enumeration Date | 2009-07-22 |
Last Update Date | 2022-11-22 |