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 |