| NPI | 1952487878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0065026) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 165710) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0064401) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD24072) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036154464) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01084853A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 325018) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.140747) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 0000062285) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0090976) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA11245000) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME0065026) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME0065026) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-01-07 |