| NPI | 1699069138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MO 2018027899) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301098239) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO 2018027899) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 57604) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KS 04-40962) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IA MD-42080) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2024-04-23 |