| NPI | 1003973959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 7853) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 75481) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 75481) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NH 7853) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-06-20 |