| NPI | 1902874605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-5983) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: HI MD-5983) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2014-09-01 |