NPI | 1174579536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0056515) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME0056515) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2010-07-16 |