| NPI | 1710990189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD 14065) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 00034632) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD14065) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00034632) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2010-02-19 |