| NPI | 1447508460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME113014) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME113014) |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2016-01-05 |