NPI | 1992061436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX U9696) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD60739932) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD182379) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2024-07-15 |