| NPI | 1447416128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: NH 14095) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME 110923) |
| 2084P0805X (Licence: CA C56143) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C56143) | |
| 2084P0805X (Licence: ME MD18951) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD449053) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 268558-1) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2022-02-09 |