| NPI | 1689787673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042.0011364) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042 0011364) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2019-11-27 |