NPI | 1992745616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MA 155915) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA 155915) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2014-11-05 |