| NPI | 1881444941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit (Licence: FL 11031091) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL 11031091) |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-03-22 |