| NPI | 1750614467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 31926) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AZ 31926) |
| Enumeration Date | 2009-09-13 |
| Last Update Date | 2009-09-13 |