| NPI | 1306070149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME112146) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME112146) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A128202) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2023-12-20 |