| NPI | 1346700507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME160938) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME160938) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2024-12-19 |