NPI | 1811123318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IA 40363) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 40363) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-8715) | |
Enumeration Date | 2009-06-10 |
Last Update Date | 2018-05-15 |