| NPI | 1932293727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 6147456-1204) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: UT 6147456-1204) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID O-0961) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-08-20 |