| NPI | 1821086323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME54622) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: FL ME54622) |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: CO DR.0036619) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ND 19828) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0036619) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: FL ME54622) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CO DR.0036619) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2024-01-16 |