| NPI | 1790882439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL me54582) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL me54582) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL me54582) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-03-17 |