| NPI | 1821250077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 30931) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 36.154753) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 42.0016474) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME158707) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 66079) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-04-17 |