| NPI | 1639269269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 12843) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 50461) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 159682-1205) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: UT 159682-1205) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: UT 159682-1205) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-08-16 |