NPI | 1548360035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 41231) |
Additional Taxonomies | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities (Licence: MA 41231) |
2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA 41231) | |
2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: MA 41231) | |
Enumeration Date | 2006-09-24 |
Last Update Date | 2013-12-30 |