NPI | 1740270214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 81171) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 81171) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 81171) | |
Enumeration Date | 2005-10-26 |
Last Update Date | 2024-07-19 |