| NPI | 1578574497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME16083) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME16083) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2024-03-11 |