| NPI | 1205030483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 239917) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME160929) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 70546) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-17027) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11299800) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0015694) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 64825) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61368209) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 325121) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U2014) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2023-07-25 |