| NPI | 1700977840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 42694) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2004016539) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CA 175682) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-08-23 |