| NPI | 1972538692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 38948) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 38948) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 38948) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-04-06 |