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 |