| NPI | 1528026101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME MD19711) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35043231G) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME TD121062) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2016-06-22 |