| NPI | 1629065529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME134480) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA08883400) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN md12692) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2019-09-16 |