| NPI | 1649322595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 23242-020) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 23242020) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 23242020) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 23240-020) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-12-20 |