| NPI | 1912902073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 32292-020) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME 68495) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA G85657) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AZ 23336) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60213513) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 68495) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G85657) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 32292-020) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 23336) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2021-04-07 |