| NPI | 1649706326 |
|---|---|
| Other Name | KENNY SQUIRES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID O-1978) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR PG183059) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2024-05-15 |