| NPI | 1801832159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PR 11281) |
| Additional Taxonomies | 174400000X Specialist |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 11281) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-06-13 |