| NPI | 1649356866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 12885) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: WV 12885) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WV 12885) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: WV 12885) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2011-04-18 |