| NPI | 1467730200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 20219) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 265297) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 265297) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NH 20219) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2023-10-19 |