| 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 |