| NPI | 1679864441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: ND 12818) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SD 9968) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 58770) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 4382) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ND 12818) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MN 58770) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: SD 9968) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2024-02-16 |