| NPI | 1447286968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME122442) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: RI MD11214) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2015-07-07 |