| NPI | 1841308632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301505995) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD21696) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD21696) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-03-07 |