| NPI | 1497866701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 0420011198) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH RT 1369) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042.0011198) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-08-12 |