| NPI | 1598151508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID M-17310) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 59845) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-17310) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-08-11 |