| NPI | 1609821206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 22550) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 22550) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME94659) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME94659) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-06-19 |