NPI | 1790775450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 61608-20) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301106248) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2020-11-23 |