NPI | 1427315126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME164516) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101262184) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME123938) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME123938) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101262184) | |
Enumeration Date | 2012-04-19 |
Last Update Date | 2023-10-06 |