| NPI | 1891757977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: MI 4301068885) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 4301068885) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MI 4301068885) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |