| NPI | 1174631113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME142617) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME142617) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 16229) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042-0015754) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 314619) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 16229) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 86746) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-03-11 |