| NPI | 1699781591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 023786) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: LA R019642 / L023786) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA R019642 / L023786) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA R019642 / L023786) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-01-25 |