| NPI | 1992794887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 011403) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: LA 011403) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-07-21 |