NPI | 1730239732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TX U0183) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 25179) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2023-05-09 |