NPI | 1346366010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A101837) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME103250) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A101837) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME103250) | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2022-11-04 |