| NPI | 1740676154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OK 5965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 5965) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 5965) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2023-10-04 |