| NPI | 1730281668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NH 14590) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0011961) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VT 042-0011961) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-08-18 |