| NPI | 1629251301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OR 19354) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR 19354) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2011-11-28 |