| NPI | 1760597082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 26049) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 13357) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.37327) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H8837) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ME 061584) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME 016584) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2018-10-17 |