NPI | 1144232257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME151389) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 232633-1) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME151389) | |
Enumeration Date | 2006-08-13 |
Last Update Date | 2024-01-15 |