NPI | 1649615998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2015-01990) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2015-01990) |
Enumeration Date | 2013-04-30 |
Last Update Date | 2020-02-06 |