| NPI | 1871535534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 277173) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 35084) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101284621) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD12140) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 043151) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 338440) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME179175) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 61865) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD29348) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C207425) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 109819) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-03114) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA12996600) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD493016) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX W0750) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2026-05-07 |