| NPI | 1730177700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 15244) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IN 01027750A) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 56064) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-03-07 |