| NPI | 1215378336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: FL ME119927) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD462734) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME119927) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA09384200) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2024-03-26 |