| NPI | 1730317967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 67176-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-135435) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 67176-20) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-08-26 |